ABSTRACT
Sepsis and septic shock have remained a persistent and recurrent source of mortality in surgical intensive care unit (ICU) patients. Sepsis and infections have been recognized as a perplexing cause of mortality since at least 1000 BC. Surviving Sepsis Campaign guidelines from 2004, have incorporated the early goal-directed therapy (EGDT) into the first 6-hour sepsis resuscitation bundle, although it has been found to increase resource demand unnecessarily without reducing mortality, length of stay, or organ dysfunction. Sepsis and septic shock remain a major source of morbidity and mortality in the surgical ICU. Although early recognition and treatment remains the cornerstone of sepsis management, further well-designed trials have shown that there was no difference in mortality between EGDT and standard management. The manifestations of sepsis and evolution of septic shock can no longer be attributed only to the infectious agent and the immune response it creates, but also to significant alterations in coagulation, immunosuppression, and organ dysfunction.
